Medical device having a rotatable working channel and related methods of use

ABSTRACT

A medical device comprising a shaft, a handle housing a proximal end of the shaft, a first channel extending throughout a lumen of the shaft, wherein the first channel is rotatable about a longitudinal axis of the shaft, the channel including a proximal end and a distal end, and an actuator, wherein a distal end of the actuator is configured to engage and disengage with the proximal end of the first channel, such that in an engaged position the actuator and the first channel are rotatable.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority from U.S. ProvisionalApplication No. 63/073,952, filed on Sep. 3, 2020, which is incorporatedby reference herein in its entirety.

TECHNICAL FIELD

This disclosure relates generally to a medical device including aworking channel that is rotatable, relative to the handle and the shaftof the medical device. At least some embodiments of the disclosurerelate to a medical device having a working channel contained within alumen of a medical device shaft.

BACKGROUND

In certain medical procedures, physicians and/or technicians need tocontrol medical accessory devices that extend through the workingchannel of an endoscope. Such control may include the rotation ofaccessory devices within the working channel of the medical device.Physicians, at times, have difficulty rotating accessory devicesextending through a fixed working channel due to the frictional forcesbetween the device and the channel. In an attempt to overcome saidfrictional forces, physicians may apply an excessive rotational forceonto the accessory device. This may cause a build-up of torque andtension between the accessory device and the working channel, and resultin 1) damaging the accessory device, or 2) whipping the accessory devicesuch that the distal end of said device will over-rotate relative to thedesired degree of rotation. As a result, medical procedures may sufferfrom the above-discussed difficulties in controlling accessory devices.

SUMMARY OF THE DISCLOSURE

According to an example, a medical device may comprise a shaft, a handlehousing a proximal end of the shaft, a first channel extendingthroughout a lumen of the shaft, wherein the first channel is rotatableabout a longitudinal axis of the shaft, the channel including a proximalend and a distal end, and an actuator, wherein a distal end of theactuator is configured to engage and disengage with the proximal end ofthe first channel, such that in an engaged position the actuator and thefirst channel are rotatable. The actuator may comprise an elongated bodythat includes a lumen extending therethrough from a proximal end to adistal end of the elongated body.

In another example, the medical device may further comprise an actuatorchannel in fluid communication with the lumen of the shaft, wherein theactuator channel extends along an axis that is transverse to thelongitudinal axis of the shaft, and the actuator channel sheaths atleast a portion of the elongated body. The actuator may be configured totranslate along a longitudinal axis of the actuator channel to engageand disengage the proximal end of the first channel, and the actuator isconfigured to rotate about a longitudinal axis of the actuator channel.The actuator is biased away from engagement with the proximal end of thefirst channel. The actuator may be spring-biased.

In another example, the medical device may further comprise a springcoiling around a portion of the elongated body that extends proximallyoutside of the actuator channel, wherein the spring is positionedbetween a distal surface of a knob and a proximal surface of theactuator channel.

In another example, the distal end of the actuator may include a firstplurality of teeth protruding distally, wherein each of the firstplurality of teeth is separated from one another by gaps along acircumference of the distal end of the actuator, and wherein theproximal end of the first channel includes a second plurality of teethprotruding proximally, wherein each of the second plurality of teeth isseparated from one another by gaps along a circumference of the proximalend of the first channel. Each of the first plurality of teeth of theactuator may be configured to fit in each of the gaps of the firstchannel, and each of the second plurality of teeth of the channel may beconfigured to fit in each of the gaps of the actuator, thereby engagingthe distal end of the actuator with the proximal end of the firstchannel.

In another example, a distal end of the shaft may include a distalabutment configured to abut against the distal end of the first channel,thereby inhibiting further distal movement of the first channel past thedistal abutment. A proximal portion of the shaft may include a proximalabutment configured to inhibit further proximal movement of the firstchannel past the proximal abutment.

In another example, a proximal opening of the first channel may comprisea ring configured to receive at least one accessory device, and seal theproximal opening of the channel from fluid. A distal portion of thechannel may comprise a holder configured to hold a distal portion of atleast one accessory device passing through the distal opening of thechannel. The handle may include a knob having a disc shape. The firstchannel may be configured to provide suction and/or insufflation throughthe distal opening of the first channel.

According to another example, a medical device may comprise a shaftincluding a lumen, a handle housing a proximal portion of the shaft,wherein the handle includes an opening leading to an actuator channel influid communication with the lumen of the shaft, a first channelextending throughout a lumen of the shaft, wherein the channel isrotatable about a longitudinal axis of the shaft, the first channelincludes a proximal end and a distal end, and an actuator, wherein aportion of the actuator is sheathed within the actuator channel, theactuator is configured to translate along a longitudinal axis of theactuator channel to engage the proximal end of the first channel, and arotation of the actuator, while engaged to the proximal end of the firstchannel, causes a simultaneous rotation of the first channel. Theactuator may comprise a knob and an elongated body, wherein theelongated body includes a lumen extending therethrough from a proximalend and a distal end of the elongated body, the knob is fixed to theproximal end of the elongated body, and the knob includes an openingthat is in fluid communication with the lumen of the elongated body. Theactuator may be biased away from engagement with the proximal end of thefirst channel. The medical may further comprise a spring coiling arounda portion of the elongated body that extends proximally outside of theactuator channel, wherein the spring is positioned between a distalsurface of the knob and a proximal surface of the actuator channel,thereby biasing the actuator away from the proximal end of the firstchannel.

According to an example, a method of rotating an accessory device housedwithin a medical device, wherein the medical device comprises a firstchannel extending throughout a lumen of a shaft, wherein the firstchannel is rotatable about a longitudinal axis of the shaft, and anactuator configured to engage and rotate the first channel, wherein theaccessory device extends within the first channel, and the first channelgrips a distal portion of the accessory device, may include inserting adistal end of a shaft of the medical device into a body of a subject,and after the insertion step, engaging the actuator with the channel,and rotating the actuator, thereby rotating both the channel and theaccessory device relative to the shaft.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate various exemplary embodiments andtogether with the description, serve to explain the principles of thedisclosed embodiments.

FIG. 1 is a partial cross-sectional view of a medical device, accordingto an embodiment.

FIG. 2A is a partial cross-sectional view of a portion of the medicaldevice of FIG. 1 .

FIG. 2B is a partial cross-sectional view of a portion of a medicaldevice according to another embodiment.

FIGS. 3A-3C are partial cross-sectional views of a portion of themedical device of FIG. 1 .

DETAILED DESCRIPTION

Reference will now be made in detail to aspects of the disclosure,examples of which are illustrated in the accompanying drawings. Whereverpossible, the same or similar reference numbers will be used through thedrawings to refer to the same or like parts. The term “distal” refers toa portion farthest away from a user when introducing a device into asubject (e.g., a patient). By contrast, the term “proximal” refers to aportion closest to the user when placing the device into the subject.

Both the foregoing general description and the following detaileddescription are exemplary and explanatory only and are not restrictiveof the features, as claimed. As used herein, the terms “comprises,”“comprising,” “having,” “including,” or other variations thereof, areintended to cover a non-exclusive inclusion such that a process, method,article, or apparatus that comprises a list of elements does not includeonly those elements, but may include other elements not expressly listedor inherent to such a process, method, article, or apparatus. In thisdisclosure, relative terms, such as, for example, “about,”“substantially,” “generally,” and “approximately,” are used to indicatea possible variation of ±10% in a stated value or characteristic.

Embodiments of the disclosure may solve one or more of the limitationsin the art. The scope of the disclosure, however, is defined by theattached claims and not the ability to solve a specific problem. Thedisclosure is drawn to a medical device including a working channel. Theworking channel may be rotatable clockwise or counter-clockwise byengagement with a port key, relative to a handle and a shaft of themedical device. The medical device can be, as an example, any scope(e.g., bronchoscope, duodenoscope, endoscope, colonoscope, ureteroscope,etc.), catheter, tool, instrument, or the like, having a shaft thatextends distally from a handle. The working channel, likewise, mayextend distally from a handle within a lumen of said shaft. In someembodiments, medical devices include a working channel that may berotatable by engagement with a key extending through a lumen of a porton the medical device handle. Said key may be in one of two states—1) adefault state, in which the key is not engaged with the working channel;and 2) an engaged state, in which the key is engaged with the workingchannel. The key may include a portion, e.g., a knob, that is outside ofthe port, and is accessible to a user. A user may interact with saidportion (e.g., press, turn) to engage the port key with the workingchannel. The user may also rotate the key while in the engaged state,thereby simultaneously rotating the working channel.

The working channel is configured to receive at least one accessorydevice and to hold a distal portion of said accessory device via anysuitable means (e.g., sphincter, collet). Thus, as the working channelis rotated, the accessory device rotates as well. Such a working channeleliminates the need for a user to manually rotate the accessory deviceby exerting rotational forces onto a proximal portion of said accessorydevice. Thus, said working channel minimizes the risks of damaging theaccessory device, or causing the accessory device to whip. Furtherdetail regarding the key, and the manner in which the key transitionsbetween the aforementioned states are discussed below when referencingFIGS. 2A-2B, and 3A-3C.

Referring to FIG. 1 , a medical device 1, e.g., a bronchoscope,according to an embodiment is shown. Medical device 1 includes aflexible shaft 24 (e.g., a catheter) and a handle 5 receiving a proximalportion of shaft 24. A proximal portion of shaft 24 may extend along alongitudinal axis of handle 5, and may be fixedly held within handle 5by any suitable means. In some embodiments, a distal end of shaft 24 mayinclude a distal abutment 26, which extends radially inward, toward thecentral axis of shaft 24. The degree by which distal abutment 26 extendsradially inward is not particularly limited, so long as medicalaccessory devices are able to extend distally through a distal openingof shaft 24. In other embodiments, a proximal portion of shaft 24 mayalso include a proximal abutment 28, which also extends radially inward,toward the central axis of shaft 24. Distal abutment 26 and proximalabutment 28 (FIG. 3A) may serve the purpose of containing a workingchannel 12 (described in further detail below) within shaft 24.Abutments 26 and 28 may also limit the longitudinal mobility of channel12 within shaft 24.

Medical device 1 further includes working channel 12 that extendsthroughout at least a portion of the lumen of shaft 24. Channel 12includes a proximal end 12 a and a distal end 12 b. Proximal end 12 aincludes a proximal opening 15 (shown in FIG. 3B) leading to the openingof the lumen 17 of channel 12. Proximal end 12 a is configured to beengaged by another component or means. For example, proximal end 12 amay include a series of teeth protruding proximally (shown in greaterdetail in FIGS. 2A-2C), configured to engage and interlock with anotherseries of teeth. However, proximal end 12 a is not limited to includingteeth, and may include any other suitable means configured forengagement. Distal end 12 b includes a distal opening 12 c in fluidcommunication with the lumen and proximal opening 15 of channel 12.Distal end 12 b further includes a sphincter 14, or any other suitablemeans, configured to grip onto a distal portion of a medical accessorydevice 100 (shown in FIG. 3A) extending through channel 12 and out ofthe distal opening. The manner in which sphincter 14 is coupled todistal end 12 b is not particularly limited. For example, sphincter 14may be securely fitted just proximal to distal opening 12 c of distalend 12 b, within lumen 17, by any suitable means, such as an adhesive.The material of sphincter 14 is not particularly limited, and, forexample, may be a flexible, rubber material, e.g., silicon, BUNA-N.Furthermore, the structural shape of sphincter 14 is not particularlylimited as well. For example, in some embodiments, sphincter 14 may beof an annular, ring like structure. In other embodiments, sphincter 14may be an elastomeric slit valve. In some other embodiments, sphincter14, may be in the shape of a pinhole, an o-ring, or may be a taperedportion of channel 12 including a flexible pinhole opening at the distalend. Sphincter 14 may include a central opening 16 configured tosecurely grip at least one accessory device 100 extending therethrough.However, it is noted that distal end 12 b is not limited to includingsphincter 14, but may include any suitable means configured to hold orgrip a distal portion of an accessory device 100 extending out of thedistal opening, e.g., a collet.

Channel 12 may be positioned within shaft 24, so that distal end 12 brests against distal abutment 26, and proximal end 12 a is adjacentlydistal to the point at which a lumen 25 (shown in FIGS. 2A-2B) ofchannel 22 and the lumen of shaft 24 meet. In some embodiments, proximalend 12 a may also be positioned distal to proximal abutment 28 on aproximal portion of shaft 24. Thus, in such embodiments, channel 12 maybe contained between distal abutment 26 and proximal abutment 28.Channel 12 is fitted within the lumen of shaft 24 such that an outersurface of channel 12 may be flush against an inner surface of shaft 24,while allowing the rotation of channel 12 within the lumen of shaft 24.Alternatively, channel 12 is fitted within the lumen of shaft 24 toleave some annular space between the outer surface of channel 12 and theinner surface of shaft 24, to minimize friction forces during rotation.Channel 12 may be configured to receive accessory medical devices, andalso provide suction or insufflation.

Handle 5, or some other device for actuating or controlling medicaldevice 1 and any tools or devices associated with medical device 1,includes an actuating device 43. Actuating device 43 controlsarticulation of flexible shaft 24, and/or an articulation joint at adistal end of flexible shaft 24, in multiple directions. Device 43 maybe, for example, a rotatable knob that rotates about its axis topush/pull actuating elements, e.g., steering wires (not shown). Theactuating elements, such as cables or wires suitable for medicalprocedures (e.g., medical grade plastic or metal), extend distally froma proximal end of medical device 1 and connect to a distal portion offlexible shaft 24 to control movement thereof. Alternatively, oradditionally, a user may operate actuating elements independently ofhandle 5. Distal ends of actuating elements may extend through flexibleshaft 24 and terminate at an articulation joint and/or a distal tip offlexible shaft 24. For example, one or more actuating elements may beconnected to an articulation joint, and actuation of actuating elementsmay control the articulation joint or the distal end of flexible shaft24 to move in multiple directions (e.g. up/down and or left/right). Inaddition, one or more electrical cables (not shown) may extend from theproximal end of medical device 1 to the distal end of flexible shaft 24and may provide electrical controls to imaging, lighting, and/or otherelectrical devices at the distal end of flexible shaft 24, and maytransmit imaging signals from the distal end of flexible shaft 24proximally to be processed and/or displayed on a display.

Handle 5 may also include ports 46, 11 for introducing and/or removingtools, fluids, or other materials from the patient. Port 46 may beconnected to an umbilicus for introducing fluid, suction, insufflation,and/or wiring for electronic components. Port 11 may be used tointroduce accessory devices 100. Port 11 receives a channel 22 thatextends along an axis that is transverse to the longitudinal axis ofshaft 24. The shape and length of channel 22 is not particularlylimited. Channel 22 connects to shaft 24, so lumen 25 of channel 22(shown in FIGS. 2A-2B) and the lumen of shaft 24 are in fluidcommunication with one another. Channel 22 is configured to house/sheathat least a portion of a port key 30.

Port key 30 includes a longitudinal body 32 and a knob 34. Body 32 maybe a hollow, tubular body comprising a lumen 38 (shown in FIG. 2A)configured to receive a medical accessory device(s) 100. The length ofbody 32 is not particularly limited, so long as a distal end of body 32may engage with a proximal end 12 a of a working channel 12 when body 32is translated towards channel 12 (further discussed below). A distal endof body 32 may include a means for engaging proximal end 12 a of channel12. For example, the distal end of body 32 may include a series of teethprotruding distally (shown in greater detail in FIGS. 2A-2C), configuredto engage and interlock with the series of teeth protruding fromproximal end 12 a. However, said distal end is not limited to includingteeth, and may include any other suitable means configured forengagement with proximal end 12 a. A proximal end of body 32 may befixed or connected to knob 34. The manner in which body 32 isfixed/connected to knob 34 is not particularly limited. Knob 34 may beof a disc-shape, but is not limited thereto. Knob 34 may be of anysuitable shape or design that allows for a user to turn or press knob34, thereby rotating body 32 about or translating body 32 along thelongitudinal axis of channel 22. Knob 34 comprises an opening 36, whichis in fluid communication with the lumen of body 32. Opening 36 isconfigured to receive a medical accessory device(s) 100, which mayextend through both opening 36 and the lumen of body 32.

As shown in FIG. 2A, at least a portion of body 32 is sheathed within alumen 25 of channel 22. An annular space may be defined between an outersurface of body 32 and an inner surface of channel 22. Alternatively, inother embodiments, body 32 may be flush against an inner surface ofchannel 22, while also being able to freely translate along or rotateabout the longitudinal axis of channel 22. Furthermore, a spring 42coils around the portion of body 32 that extends proximally outside ofchannel 22. Spring 42 is positioned between a distal surface of knob 34and a proximal surface of channel 22, and the ends of spring 42 may becoupled to the aforementioned surfaces by any suitable means. Thus, dueto the extension of spring 42, key 30 may be biased away from engagementwith channel 12 by default. Also, by coupling spring 42 to theaforementioned surfaces, key 30 may be inhibited from falling out fromthe proximal opening of channel 22.

FIG. 2A further illustrates the presence of a channel O-ring 23 and akey O-ring 33. Both O-rings 23 and 33 are annular rings of any suitablematerial, preferably a flexible, rubber-like material, e.g., silicon,BUNA-N, etc. As shown, channel O-ring 33 is fitted around body 32 of key30, in the annular space between an outer surface of body 32 and aninner surface of channel 22. The longitudinal placement of O-ring 23with respect to body 32 is not particularly limited. O-ring 23 can beplaced at any suitable longitudinal position about body 32. O-ring 33may serve as a seal that inhibits foreign materials or fluids fromentering and exiting channel 22. Key O-ring 33 may be fitted withinlumen 38 of key 30. The longitudinal placement of O-ring 33 within lumen38 is not particularly limited. O-ring 33 can be placed at any suitablelongitudinal position within lumen 38. Given the annular shape of O-ring33, accessory devices or instruments 100 may be inserted through acentral opening of O-ring 33. Moreover, O-ring 33 may serve as a sealthat inhibits foreign materials or fluids from entering and exiting key30 via lumen 38.

FIG. 2B illustrates an example of a different sealing means for channel22′ and key 30′. Channel 22′ may be structured so that lumen 25′includes a tapered portion 21 between the proximal and distal ends oflumen 25′. Tapered portion 21 is tapered radially inwards until theinner surface of channel 22′ contacts body 32′, and is then taperedradially outward to the diameter of lumen 25′ proximal and distal to thetapering. Tapered portion 21 effectively serves as a seal that inhibitsforeign materials or fluids from entering and exiting channel 22′.

Similarly, key 30′ may be structured so that lumen 38′ tapers at taperedportion 31. Lumen 38′ may be tapered so that a pinhole 37 remains in thecenter of tapered portion 31. Pinhole 37 allows for accessory devices orinstruments 100 to pass through lumen 38′ via pinhole 37. The width ordiameter of pinhole 37 is not particularly limited. For example, pinhole37 may be of a similar diameter as the width of accessory devices orinstruments 100. However, tapered portion 31 may be of a flexiblematerial that allows for pinhole 37 to flex and receive devices orinstruments of larger widths. Given the ability of pinhole 37 tostretch/flex, pinhole 37 may be of a smaller diameter and taperedportion 31 may effectively serve as a seal that inhibits foreignmaterials or fluids from entering and exiting key 30′.

As noted above, tapered portions 21, 31 are structural features ofchannel 22′ and key 30′. To accommodate for tapered portions 21, 31 thatare more flexible relative to the remaining structures of channel 22′,and key 30′, channel 22′ and key 30′ may be of a rubber like material,e.g., silicon, BUNA-N, of a higher durometer. Tapered portions 21, 31may be of the same material, but of a lower durometer. This variance indurometer levels may be achieved by any suitable means. For example,tapered portions 21, 31 may be injection molded onto channel 22′ and key30′, and the mold may be of the same materials (as channel 22′, key 30′)having lower durometers.

It is further noted that sealing means are not limited to theembodiments shown in FIGS. 2A and 2B. For example, device 1 may bewithout O-ring 23 or tapered portion 21 when body 32 may be flushagainst an inner surface of channel 22. Thus, various combinationsand/or configurations of the above-described sealing means may beimplemented.

Furthermore, medical device 1 may include a strain relief 23 that isattached to a distal end of handle 5. Strain relief 23 may be a cover ofany suitable soft material that tapers distally and has an opening forshaft 24 at its distal end. Strain relief 23 is not particularlylimited, and may assist in preventing shaft 24 from kinking.

FIG. 3A illustrates another view of key 30 in its default state. FIG. 3Ashows the distal end of body 32 including a series of teeth 58protruding distally, each tooth being separated from one another by anequal distance along a circumference of a distal tip of body 32. FIG. 3Ashows accessory device 100. FIG. 3A also shows proximal end 12 aincluding a series of teeth 52 protruding proximally, each tooth beingseparated from one another by an equal distance along a circumference ofproximal end 12 a. As indicated by the directional arrow, key 30 maytranslate along the longitudinal axis of channel 22, therebytransitioning from a default state to an engaged state. This may be doneby pressing or pushing against knob 34 with a sufficient amount of forceto compress spring 42, and driving key 30 towards proximal end 12 a ofworking channel 12. The manner by which knob 34 is pressed or pushedagainst is not particularly limited. Although teeth 52, 58 areillustrated as a plurality of castellations, it is understood that teeth52, 58 may be any protrusion/recess and corresponding reverseconfiguration such that the key 30 and channel 12 are selectivelyengageable and disengageable.

FIG. 3B illustrates a view of key 30 in its engaged state. In theengaged state, spring 42 is compressed and key 30 is advanced towardsproximal end 12 a. Teeth 58 of key 30 and teeth 52 of channel 12 areengaged and interlocked with one another such that that each of teeth 58fill the separations or gaps between each of teeth 52. When engaged,knob 34 may be rotated about a longitudinal axis of channel 22 and body32, as shown by a directional arrow, thereby rotating key 30 in the samedirection, which in turn rotates working channel 12. It is noted thatknob 34 may be rotated in either a clockwise or counter-clockwisedirection, and is not limited to the direction in which the directionalarrow points towards. The manner by which knob 34 is rotated is notparticularly limited. As previously noted, distal end 12 b furtherincludes sphincter 14 (shown in FIG. 1 a ), or any other suitable means,configured to grip onto a distal portion of a medical accessory device100 extending out of the distal opening of channel 12. Thus, a medicalaccessory device 100 inserted into opening 36, and extending through key30 and channel 12, may be rotated (clockwise or counter-clockwise)simultaneously with channel 12.

FIG. 3C illustrates a view of key 30 reverted back to its default state.Key 30 may revert to its default state when any force pressing orpushing against knob 34 is released, thereby allowing spring 42 toextend. This reversion is indicated by the directional arrow, and key 30being in its original position, biased away from engagement with channel12.

Referring to FIGS. 1A-3C, an example of how medical device 1 may be usedis further discussed below. The distal end of shaft 24 of medical device1 may be delivered into the body of a subject, adjacent to an intendedtarget site. The delivery may be via a natural body orifice, such as themouth, nose, anus, etc. Imaging associated with medical device 1, viaany suitable image processing device, may assist in positioning of thedistal end of shaft 24. A medical accessory device 100 (as seen in FIG.3A) may then be inserted into opening 36 of key 30. The accessory device100 may be advanced towards the distal end of shaft 24, past sphincter14, which grips a distal portion of said accessory device 100. Dependingon the position of the subject and/or the intended target site relativeto medical device 1 and/or a user of medical device 1, the user maychoose to rotate the accessory device 100 relative to handle 5 and shaft24. To rotate the accessory device 100, the user may first press againstknob 34 of key 30 with a sufficient amount of force to compress spring42, and advance key 30 towards working channel 12. Key 30 may beadvanced until the distal end of key 30 and proximal end 12 a of channel12 are engaged. While engaged, the user may then turn knob 34 in aclockwise or counter-clockwise direction to rotate key 30, which causesthe rotation of channel 12 in the same direction. The rotation ofchannel 12 causes a simultaneous rotation of the medical accessorydevice 100, which is gripped by channel 12 via sphincter 14. Thus, theuser may rotate the medical accessory device 100 to any desired degree,via the rotation of knob 34. After rotating the accessory device 100 tothe desired degree, the user may release any force applied to knob 34 toallow spring 42 to de-compress, and to revert key 30 to its defaultposition, biased away from channel 12.

It will be apparent to those skilled in the art that variousmodifications and variations can be made to the disclosed device withoutdeparting from the scope of the disclosure. Other embodiments of thedisclosure will be apparent to those skilled in the art fromconsideration of the specification and practice of the inventiondisclosed herein. It is intended that the specification and examples beconsidered as exemplary only, with a true scope and spirit of theinvention being indicated by the following claims.

What is claimed is:
 1. A medical device, comprising: a shaft; a handlehousing a proximal end of the shaft; a first channel extendingthroughout a lumen of the shaft, wherein the first channel is rotatableabout a longitudinal axis of the shaft, the first channel including aproximal end and a distal end; and an actuator, wherein a distal end ofthe actuator is configured to engage and disengage with the proximal endof the first channel, such that in an engaged position the actuator andthe first channel are rotatable, wherein a distal end of the shaftincludes a distal abutment configured to abut against the distal end ofthe first channel, thereby inhibiting further distal movement of thefirst channel past the distal abutment.
 2. The medical device of claim1, wherein the actuator comprises an elongated body that includes alumen extending therethrough from a proximal end to a distal end of theelongated body.
 3. The medical device of claim 2, further comprising anactuator channel in fluid communication with the lumen of the shaft,wherein the actuator channel extends along an axis that is transverse tothe longitudinal axis of the shaft, and the actuator channel sheaths atleast a portion of the elongated body.
 4. The medical device of claim 3,wherein the actuator is configured to translate along a longitudinalaxis of the actuator channel to engage and disengage the proximal end ofthe first channel, and the actuator is configured to rotate about alongitudinal axis of the actuator channel.
 5. The medical device ofclaim 2, further comprising a spring coiling around a portion of theelongated body that extends proximally outside of an actuator channel,wherein the spring is positioned between a distal surface of a knob anda proximal surface of the actuator channel.
 6. The medical device ofclaim 2, wherein the handle includes a knob having a disc shape.
 7. Themedical device of claim 1, wherein the actuator is biased away fromengagement with the proximal end of the first channel.
 8. The medicaldevice of claim 7, wherein the actuator is spring-biased.
 9. The medicaldevice of claim 1, wherein the distal end of the actuator includes afirst plurality of teeth protruding distally, wherein each of the firstplurality of teeth is separated from one another by gaps along acircumference of the distal end of the actuator, and wherein theproximal end of the first channel includes a second plurality of teethprotruding proximally, wherein each of the second plurality of teeth isseparated from one another by gaps along a circumference of the proximalend of the first channel.
 10. The medical device of claim 9, whereineach of the first plurality of teeth of the actuator are configured tofit in each of the gaps of the first channel, and each of the secondplurality of teeth of the first channel are configured to fit in each ofthe gaps of the actuator, thereby engaging the distal end of theactuator with the proximal end of the first channel.
 11. The medicaldevice of claim 1, wherein a proximal portion of the shaft includes aproximal abutment configured to inhibit further proximal movement of thefirst channel past the proximal abutment.
 12. The medical device ofclaim 1, wherein a distal portion of the first channel comprises aholder configured to hold a distal portion of at least one accessorydevice passing through a distal opening of the first channel.
 13. Themedical device of claim 1, wherein the first channel is configured toprovide suction or insufflation through a distal opening of the firstchannel.
 14. A medical device, comprising: a shaft including a lumen; ahandle housing a proximal portion of the shaft, wherein the handleincludes an opening leading to an actuator channel in fluidcommunication with the lumen of the shaft; a first channel extendingthroughout the lumen of the shaft, wherein the first channel isrotatable about a longitudinal axis of the shaft, the first channelincludes a proximal end and a distal end; and an actuator, wherein aportion of the actuator is sheathed within the actuator channel, theactuator is configured to translate along a longitudinal axis of theactuator channel to engage the proximal end of the first channel, and arotation of the actuator, while engaged to the proximal end of the firstchannel, causes a simultaneous rotation of the first channel, whereinthe actuator comprises a knob and an elongated body, wherein theelongated body includes a lumen extending therethrough from a proximalend to a distal end of the elongated body, the knob is fixed to theproximal end of the elongated body, and the knob includes an openingthat is in fluid communication with the lumen of the elongated body. 15.The medical device of claim 14, wherein the actuator is biased away fromengagement with the proximal end of the first channel.
 16. The medicaldevice of claim 15, further comprising a spring coiling around a portionof the elongated body that extends proximally outside of the actuatorchannel, wherein the spring is positioned between a distal surface ofthe knob and a proximal surface of the actuator channel, thereby biasingthe actuator away from the proximal end of the first channel.
 17. Amethod of rotating an accessory device housed within a medical device,wherein the medical device comprises a first channel extendingthroughout a lumen of a shaft, wherein the first channel is rotatableabout a longitudinal axis of the shaft, and an actuator configured toengage and rotate the first channel, wherein the accessory deviceextends within the first channel, and the first channel grips a distalportion of the accessory device, the method comprising: inserting adistal end of a shaft of the medical device into a body of a subject;and after the insertion step, engaging the actuator with the firstchannel, and rotating the actuator, thereby rotating both the firstchannel and the accessory device relative to the shaft.